Research linking HRT to cancer 'flawed'

By Jill Stark

MENOPAUSE specialists have slammed new research linking hormone replacement therapy to increased breast cancer deaths, saying the evidence is flawed and alarmist.

Results published last week from a study of more than 16,000 post-menopausal women found that those who had taken combined oestrogen and progesterone HRT were more likely to die from the disease.

It comes from a new analysis of the 2002 study which first linked the drugs to breast cancer and prompted women across the world to stop taking hormone drugs.

But Professor Henry Burger, emeritus director of Melbourne's Prince Henry Institute, told The Sunday Age the 11-year, US government-backed Women's Health Initiative trial was now widely acknowledged as flawed, and the latest results from it perpetuated unnecessary fear.

''Only 3.5 per cent (of trial subjects) were in the 50-to-54-year age group, which would be (when) you might start someone on hormone therapy,'' he said.

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The analysis, published in the Journal of the American Medical Association, found a higher rate of invasive breast cancer and death in those who had taken HRT compared to those on a placebo.

What was not widely reported last week was that the trial's lead author, Rowan Chlebowski, had conceded that the risk of breast cancer death barely met the threshold for being considered statistically significant.

Professor Burger said the overall mortality rate, from any cause, was also lower in the women who had taken HRT than those in the control group.

Leading menopause specialist Alastair MacLennan, head of Adelaide University's obstetrics and gynaecology department, warned that unwarranted alarmism about HRT, fuelled by the WHI trial, was partly to blame for a shift towards potentially dangerous bio-identical hormones.

Four per cent of women over 50 are taking bioidenticals - up from virtually zero use before the 2002 trial.

Like conventional HRT, the drugs contain oestrogen and progesterone, sourced from yams or soybeans and synthesised to mimic hormones depleted during menopause.

They were a ''complete scam'', Professor MacLennan said.

''Women are paying five to six times as much (as HRT) for homemade or pharmacy compounded mixtures of imported hormones, mostly from China, which do not go through the TGA's quality control, and are made up in mixtures that have never been tested for their efficacy and safety,'' he said.